Describe the treatement approach.
Check for criteria for severe malaria.
Treat severe malaria immediately with IV artesunate.
Treat uncomplicated malaria based on species, resistance patterns, and degree of chemoprophylaxis.
Report all confirmed malaria to public health authorities.
Describe the pharmacotherapy of severe malaria.
Start IV artesunate
Repeat malaria parasite density after 3rd dose of artesunate.
> 1%: Continue IV artesunate
≤ 1%: Switch to oral antimalarials
OR quinidine (in the US; quinine elsewhere)
List further treatment measures for severe malaria.
Supportive care and monitoring
Disposition: Admit to ICU.
Describe the treatment of uncomplicated malaria.
Agent selection based on:
Infecting Plasmodium species
Prior use of chemoprophylaxis
Likelihood of chloroquine-resistance
See “Overview of treatment of uncomplicated malaria.”
Additional considerations in P. vivax and P. ovale
Check G6PD activity levels.
Give primaquine or tafenoquine to eradicate hypnozoites dormant in hepatocytes.